Risk factors, treatments, and outcomes associated with prolonged hyperemesis gravidarum

Abstract

Objective To identify factors associated with prolonged Hyperemesis Gravidarum (HG). Study Design About 395 women completed a survey regarding pre-existing conditions, treatments and outcomes. Responses were compared using two-sided t-test or the F-test. Results Participants with prolongs HG are slightly younger and weight more. Pre-existing factors associated with prolonged HG include allergies and a restrictive diet. Prolonged HG is associated with hematemesis, dizziness, fainting and antiemetic treatment. Following pregnancy, those with prolonged HG reported more posttraumatic stress, motion sickness, muscle weakness and infants with irritability, severe colic and growth restriction. Conclusion Multiple pre-existing conditions and poor maternal and infant outcomes were associated with prolonged HG. The most significant condition prior to pregnancy was allergies suggesting a possible autoimmune component affecting duration of HG. In addition, the most significant lifestyle choice linked to prolonged HG was a restrictive diet. Future research is needed to determine whether a change in diet prior to pregnancy may lead to a shorter duration of HG and its associated outcomes.

Pregnancy outcomes in severe hyperemesis gravidarum in a multi-ethnic population

“…It still remains elusive whether such diff erences can be attributed to genetic factors related to ethnicity aff ecting outcomes in women with HG, or whether they could be a result of cultural diff erences aff ecting reporting of symptomology. HG is associated with elevated levels of PAPP-A and free β -hCG, as reported by a recent study in the Turkish population (Derbent et al 2011) and numerous other parameters have been analysed in the literature; among those are allergies suggesting a possible autoimmune component and a restrictive diet (Mullin et al 2012). Helicobacter pylori have also been proposed as a possible aetiological factor for HG but this remains controversial (Karadeniz et al 2006).…”

Is there any effect of demographic features on development of hyperemesis gravidarum in the Turkish population?

“…Mullin et al (24) concluded that no significant differences were observed between the control group and the HG short-duration group (HG symptoms that resolved before 27 gestational weeks). However, members of the HG long-duration group (symptoms lasting until birth) were significantly more likely to be younger and weigh more than members of the other groups.…”

Management of severe pregnancy sickness and hyperemesis gravidarum

“…Historically, the aetiology of HG was poorly understood and it was thought to be caused by endocrine, infectious, psychosocial, and hereditary factors 4. However, recent studies in twins showed that severity and duration of NVP are highly genetic 8.…”

“…A meta-analysis of observational studies showed other risks during pregnancy include low birth weight (<2500 kg; odds ratio 1.42; 95% confidence interval 1.27 to 1.58), preterm labour (odds ratio 1.32; 95% confidence interval 1.04 to 1.68), small for gestational weight babies (odds ratio 1.28; 95% confidence interval 1.02-1.60) 42938. Case reports have identified vitamin deficiencies 39.…”

“…By contrast, hyperemesis gravidarum (HG) is a complication of pregnancy rather than a normal part of it and occurs in around 1.5% of pregnancies 3. It is not unusual for HG to persist throughout pregnancy 45. The psychosocial burden of HG can be heavy for women and their families, but effective and holistic treatment may reduce this 67…”